| NPI | 1710316336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRYL M CRAWFORD Endodontist 863-413-9773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: FL DN16500) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |